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FOI 23/24 -0884 
 
OFFICIAL 
 
 
 
 
Operational Protocol for NDIS 
participants at risk.  
 
 
As agreed between the National Disability Insurance Agency and the NDIS Quality and 
Safeguards Commission 
 
Date: July 2022 
 
For internal staff use only – not for distribution 
V1.0 July 2022 – Operational Protocol for NDIS participants at risk  
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Contents 
 
Version Control ..................................................................................................................... 3 
About the Operational Protocol ................................................................................................. 4 
1. 
Purpose ............................................................................................................................ 4 
2. 
Relevant Areas of Interface .............................................................................................. 5 
3. 
Defining participant risk .................................................................................................... 5 
4. 
Identifying NDIS participants at risk ................................................................................. 5 
5. 
Joint Operational Response ............................................................................................. 7 
Proactive operational response ........................................................................................ 7 
Reactive operational response ......................................................................................... 8 
6. 
Governance .................................................................................................................... 12 
7. 
Related Documents ........................................................................................................ 12 
8. 
Key Contacts .................................................................................................................. 14 
Appendix A ......................................................................................................................... 17 
Escalation prioritisation matrix* ...................................................................................... 17 
Appendix B ......................................................................................................................... 18 
NDIS Commission Risk Indicators (draft) ........................................................................... 18 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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About the Operational Protocol 
 
The National Disability Insurance Agency (NDIA) and the NDIS Quality and Safeguards 
Commission (NDIS Commission) agreed an information sharing Statement of Intent in June 
2018 to work collaboratively in supporting each other to perform individual and shared 
responsibilities under the National Disability Insurance Scheme Act 2013 (NDIS Act). 
The NDIA and NDIS Commission each have authority under sections 60 and 66 (the NDIA), 
67A and 67E (the NDIS Commission) of the NDIS Act to disclose information to each other: 
•  For the purpose of the NDIS Act this includes purposes that are relevant to achieve the 
functions of each under the Act; 
•  With the express or implied consent of the person to whom the information relates 
(including consent of an authorised representative). Where practicable, express consent 
will be sought rather than relying on implied consent;  
•  If either party reasonably believes that the disclosure of the information is for the 
purpose of, or in relation to, preventing or lessening a threat (whether current or future) 
or reporting a past threat, to an individual’s life, health or safety; or 
•  Where the CEO of the NDIA or Commissioner of the NDIS Commission is satisfied on 
reasonable grounds that it is in the public interest to disclose the information; 
This Operational Protocol is agreed between the NDIA and the NDIS Commission. 
The NDIA and NDIS Commission will jointly monitor the implementation of this Operational 
Protocol and review its operation every 6 months. 
 
1. 
Purpose 
The National Disability Insurance Agency (NDIA) and the NDIS Quality and Safeguards 
Commission (NDIS Commission) are committed to supporting NDIS participants who, through 
data and risk indicators and assessment, are identified as 'at risk’.  
This protocol is consistent with the principles of the NDIS Act 2013 which gives effect to 
Australia’s obligations under the UN Convention on the Rights of Persons with Disabilities 
(UNCRPD). Particularly that people with disability have the right to fulfil their potential and live 
free from harm; including violence, abuse, neglect, exploitation and discrimination. Following 
the 2020 Robertson Review failings were identified in how the NDIS Commission and the NDIA 
carried out their functions and a number of recommendations were made in order to help 
strengthen supports for participants at risk. This protocol addresses Recommendation 1 of that 
review. 
The 2021 NDIS Amendment (Improving supports for at risk participants) Bill (Bill) further 
strengthens the NDIS Commissioner’s compliance and enforcement powers with the intent to 
fortify supports and protections for NDIS participants. This Bill amends provisions in the NDIS 
Act to support the implementation of changes in response to Robertson Review 
recommendations 1, 5, 6, 7, 8 and 9, and improves supports and protections provided to NDIS 
participants. 
This protocol will outline the roles and responsibilities of the NDIA and NDIS Commission in 
order to identify and respond to matters for participants who are identified as being at risk, in a 
timely manner. 
 
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2. 
Relevant Areas of Interface 
 
Priority work intersection  
Once fully implemented, this protocol will inform the NDIA Participant Safety policy, as well as 
work the NDIA is completing on family violence orders and support for decision-making.  
This protocol will also complement escalations and reporting mechanisms, such as: 
- 
NDIA Participant Critical Incident Framework  
- 
NDIA Complaints and Feedback Framework 
 
Other Joint protocol intersection 
- 
NDIA  and  NDIS  Commission  Complaints  Handling  and  Reportable  Incidents 
Operational Protocol.  
- 
NDIA and NDIS Commission Complex Supports Operational Protocol 
- 
NDIA and NDIS Commission Data Access Transfer Operational Protocol 
- 
NDIA and NDIS Commission Market Stewardship & Oversight 
- 
NDIA and NDIS Commission Regulatory Interface Operational Protocol 
 
3. 
Defining participant risk 
The NDIA and the NDIS Commission have related but different roles in identifying, 
mitigating, and responding to participant risks. As the implementing agencies of the NDIS, 
there is a need to have a shared understanding of risk, to inform the sharing of information 
and how the agencies will work together to mitigate and respond to participant risks. 
This shared understanding of risk will evolve over time as learnings are taken from 
participant/provider interactions, data analysis and research into best-practice. Further work 
will be done to define participant risk through the drafting of the NDIA Participant Safety 
Policy and the NDIS Commission Participants at Risk Policy. 
It is important to note that a person’s disability does not immediately infer that they are at risk 
of harm. However, a person’s disability, combined with their individual circumstances, access 
to protective mechanisms and quality of supports might contribute to, or increase the 
potential risk. 
At each stage of a participant’s interaction in the NDIS, consideration must be given to how 
the participant’s disability, personal history, personal circumstances and quality of supports 
might contribute to their level of risk and what the responsibilities of the NDIA and the NDIS 
Commission are to ensure that participant’s safety. 
 
4. 
Identifying NDIS participants at risk  
The NDIA and NDIS Commission have developed and agreed upon participant risk 
indicators at both an individual and population level. Further improvement of data exchange 
and sharing between agencies has commenced under the existing NDIS Commission and 
NDIA Data Access Transfer Operational Protocol. 
Current risk indicators within the NDIA were identified through five main sources: 
1.  Business intelligence 
2.  At-risk participant COVID response logic 
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The Participant Check-in requires NDIA staff and partners to: 
• Contact the participant to check their welfare and wellbeing
• Check the NDIS plan utilisation and connection with providers
• Check for other vulnerabilities/risks based on the risk indicators or other business
intelligence
• Check participant record for any NDIS Commission related activities
• Engage a support coordinator (if required)
• Refer to mainstream or community services
• Refer relevant provider or worker quality and safety matters to the NDIS Commission
• Document and agree to the next check-in.
NDIS Commission Site Visit Policy 
The NDIS Commission has responsibility to ensure NDIS providers are meeting their 
obligations. Whilst gathering and verifying information for the NDIS Commission, staff should 
visit sites where services are delivered wherever possible. Site visits provide a higher level of 
scrutiny through first-person observation and can identify risk where it may not have otherwise 
been visible.  
In order to monitor compliance of providers, the NDIS Commission also has a role in directly 
engaging with participants, guardians and family members. This includes face to face visits 
where risk factors have been identified through local or national compliance activities and other 
regulatory functions.  
A site visit can also be undertaken as a reactive response to a participant risk issue identified 
by the NDIS Commission or by the NDIA under this protocol, to monitor provider compliance 
with the NDIS code of conduct and, where applicable the NDIS practice standards. 
Reactive operational response 
Existing Protocols: 
The NDIA and the NDIS Commission have a number of joint protocols that outline how the 
NDIA and the NDIS Commission will work collaboratively to perform individual and shared 
responsibilities under the National Disability Insurance Scheme Act 2013 (NDIS Act). All 
existing joint protocols can be found on each agency’s intranet site, and are available internally 
to all staff.  
The Complaints Handling and Reportable Incidents Operational Protocol sets out the 
agreed roles and responsibilities of the NDIA and the NDIS Commission in regards to the 
effective management and resolution of NDIA participant critical incidents (PCIs), NDIS 
Commission reportable incidents (RIs) and complaints. The full definition of a PCI, RI and a 
complaint is outlined in the protocol. 
Where a participant is identified as being at-risk and there is also a PCI, RI or a complaint, the 
Complaints Handling and Reportable Incidents Operational Protocol should be followed in the 
first instance.  
The Complex Supports Operational Protocol sets out the agreed roles and responsibilities of 
the NDIA and the NDIS Commission in regards to participants who require behaviour supports 
and who may be subject to, or at risk of being subject to, restrictive practices. 
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If the matter cannot be resolved via the existing joint protocols, staff can follow the Reactive 
Escalation response outlined within this protocol.  
 
Business As Usual:  
 
It is expected that matters identified as low risk can generally be managed via business as 
usual operations, without the need for a joint operational response.  
 
Business as usual arrangements are the contacts, relationships and processes established by 
the NDIA, NDIS Commission and mainstream agencies. Business as usual arrangements 
recognise the practical benefit of close working relationships on the ground and resolving 
matters as close to the person as possible.  
The vast majority of matters, including routine requests for updates related to a NDIS 
participant or a service provider, are to be resolved in line with the respective business as 
usual arrangements for the NDIA and NDIS Commission. They may include matters relating to 
NDIA access, planning and reviews, or provider-related queries or concerns.  
 
Joint Response: 
 
Where a participant is identified by either organisation as being at risk, and the related matter is 
not more appropriately responded to under an existing joint protocol, the NDIA and NDIS 
Commission have agreed to a tiered escalation response. This response is based on the NDIA 
Escalation prioritisation matrix at Appendix A, and will be developed further, following 
workshops with operational leads.  
 
Low/Medium Risk Response 
 
Matters that are identified via the Escalation prioritisation matrix as low or medium risk are 
required to be addressed at the NDIA or NDIS Commission EL2 Director level or equivalent.  
 
Matters may escalate to this level if they are unable to be resolved via BAU processes.  
An initial response is due within 1-2 business days. A resolution, or significant progress 
toward a resolution, is due within three weeks.  
 
High Risk Response 
Matters that are identified via the Escalation prioritisation matrix as high risk are required to be 
addressed at the NDIA State/Branch Manager level, with escalation receipt and involvement 
from the NDIS Commission State/Territory Director or Branch Head Operations. 
Matters may escalate to High risk if: 
•  They are unable to be resolved via a low/medium risk response 
•  There is a dispute existing over the interpretation or implementation of operational 
policy. 
•  There are complex issues relating to the Applied Principles and Table of Supports 
(APTOS) 
•  There are systemic provider issues, including regulatory non-compliance. 
An initial response is due the same day. A resolution is due within 
2 weeks or immediately as required.  
 
Extreme Risk Response 
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Matters that are identified via the Escalation prioritisation matrix as extreme risk should be 
escalated immediately. The matter will be addressed at the NDIA General Manager/NDIS 
Commission Branch Head Operations level or equivalent with notification to the following 
representatives: 
•  NDIA  CEO,  DCEO  Participant  Experience  Delivery,  General  Manager  National 
Delivery, and relevant State/Territory Manager 
•  NDIS Commissioner, Complaints Commissioner, and Senior Practitioner or Registrar 
where relevant. 
 
An initial response is due within 2 hours. A resolution is due within 10 days or immediately as 
required. 
 
 
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6. 
Governance  
 
Protocol maintenance 
 
The Operational Protocol Secretariat will be responsible for establishing, maintaining, and 
completing protocol reviews through consultation between the NDIA and NDIS Commission 
business areas. Reviews for this protocol will occur no later than 6 monthly.  
 
Operational Working group 
 
The NDIA and NDIS Commission business areas will meet every six weeks via a working group 
to: 
•  Develop work flow and work processes between the NDIA and NDIS Commission, for 
participants at risk, including a process for developing a joint response/plan.  
•  Develop shared understanding of data access and exchange to enhance each party’s 
capacity to perform legislative functions and improve outcomes for participants. 
•  Ensure the operational protocol remains fit for purpose, documenting changes to each 
agency’s own processes which may impact on the procedures outlined in this protocol. 
 
 
Regular Meeting Schedule 
 
The working group will meet six-weekly, including relevant state and territory leads, to: 
•  reconcile and review participant data related at risk participants  
•  review current processes to work towards best practice; and 
•  set priorities for next quarter. 
Outcomes of the meeting must include administrative actions as well as ensuring alignment and 
agreement of issues such as joint communication, provider and participant education and 
learning and development activities. 
 
Communication 
 
Development of communication protocols is encouraged to establish effective working 
arrangements at the State and Territory level. 
 
Escalation 
 
Issues arising from the shared work of the NDIA and NDIS Commission and operation of these 
protocols should be raised at the Branch Manager (SES Band 1) level.  If the issue cannot be 
resolved, it will be escalated to General Manager (SES Band 2) level. 
 
 
 
7. 
Related Documents  
  •  NDIA Participant Critical Incident Framework  
•  NDIA Complaints and Feedback Framework 
•  NDIA Participant Safety Policy (coming soon) 
•  NDIS Commission Site Visit Policy 
•  NDIS Commission NDIS Search Tool Policy 
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Other Operational Protocols 
•  Data Access and Transfer  
•  Complaints Handling and Reportable Incidents 
•  Complex Supports 
•  Regulatory Interfaces (Registration, Fraud and Compliance) 
o  Addendum – Continuity of Supports 
o  Addendum – Provider Exits 
•  Market Oversight 
 
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NDIA 
Tori S22(1)(a)(ii) 
 
- irrelevant m
VIC State Manager, Service 
 
Tori.S22(1)(a)(ii) 
@ndis.go
- irrelevant m
S22(1)(a)(ii) - irrelevant material
v.au 
Delivery 
High Risk Escalations 
NDIA 
Louise S22(1)(a)(ii) - irrelevan  
Territory Manager ACT, 
S22(1)(a)(ii) - irrelevant material  
Louise.S22(1)(a)(ii) - irrelevant xxxxxxxx@xxxx.xxx.xx 
 
Service Delivery 
 
High Risk Escalations 
NDIA 
Nathan S22(1)(a)(ii) 
 
- irrelevant 
Territory Manager NT, Service 
S22(1)(a)(ii) - irrelevant material  
Nathan.S22(1)(a)(ii) 
@ndi
- irrelevant 
s.gov.au 
Delivery 
High Risk Escalations 
NDIA 
Pippa S22(1)(a)(ii) 
 
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National Delivery Division 
S22(1)(a)(ii) - irrelevant material  
Pippa.S22(1)(a)(ii) 
2@ndis.g
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ov.au  
support officer 
NDIA 
Maddi S22(1)(a)(ii) 
 
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Director, Complaints pathway 
S22(1)(a)(ii) - irrelevant material  
Maddi.S22(1)(a)(ii) 
@ndi
- irrelevant materia
s.gov.au 
NDIA 
Deb S22(1)(a)(ii) - irr   
Branch Manager, Technical 
S22(1)(a)(ii) - irrelevant material    
Deb.S22(1)(a)(ii)  @ndi
- irre
 
s.gov.au 
Advisory Branch (TAB) 
NDIA 
Julie S22(1)(a)(ii) 
 
- irrelevan  
Director, Complex Planning, 
S22(1)(a)(ii) - irrelevant material  
Julie.S22(1)(a)(ii) 
@ndi
- irrelevan  
s.gov.au 
(TAB) 
NDIA 
Katrin S22(1)(a)(ii) 
 
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Assistant Director, 
S22(1)(a)(ii) - irrelevant material  
Katrin.S22(1)(a)(ii) 
@ndis.g
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ov.au 
Core/Complex Planning (TAB) 
NDIS 
Sian S22(1)(a)(ii) 
 
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Protocol Owner 
S22(1)(a)(ii) - irrelevant material  
Sian.S22(1)(a)(ii) 
@ndi
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scommission.gov.au 
Commission 
Complaints Commissioner  
 
SES Band 2, for High and 
Extreme Risk escalations 
NDIS 
Philip S22(1)(a)(ii) 
 
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Branch Head, North Central 
S22(1)(a)(ii) - irrelevant material  
PhilipS22(1)(a)(ii) 
@ndi
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scommission.gov.au   
Commission 
West (QLD, NT, SA, WA) 
 
National Reportable Incidents 
Operations 
High Risk Escalations 
NDIS 
Mahashini S22(1)(a)(ii) 
 
- irrelevant 
A/Branch Head, South East 
S22(1)(a)(ii) - irrelevant material  
Mahashini.S22(1)(a)(ii) 
@ndiscommissio
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n.gov.au 
Commission 
(NSW, ACT, VIC, TAS) 
  
High Risk Escalations 
NDIS 
Robert S22(1)(a)(ii) - irrel   
A/State Director QLD 
S22(1)(a)(ii) - irrelevant material  
Robert.S22(1)(a)(ii) - irre@ndi
 
scommission.gov.au 
Commission  
Low/medium Risk escalations 
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NDIS 
Valli S22(1)(a)(ii) 
 
- irrelevant m
State Director NT 
S22(1)(a)(ii) - irrelevant material  
Valli.S22(1)(a)(ii) 
@ndiscom
- irrelevant m
mission.gov.au 
Commission    
Low/medium Risk escalations 
 
NDIS 
Carrie S22(1)(a)(ii) 
 
- irrelevant m
A/State Director WA 
S22(1)(a)(ii) - irrelevant material  
CarrieS22(1)(a)(ii) 
@ndi
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scommission.gov.au 
Commission    
Low/medium Risk escalations 
 
NDIS 
Tim S22(1)(a)(ii)   
- irrele
 
State Director SA 
S22(1)(a)(ii) - irrelevant material  
Tim.S22(1)(a)(ii)  @ndisco
- irrele
 
mmission.gov.au 
Commission    
Low/medium Risk escalations 
NDIS 
Andrew S22(1)(a)(ii) 
 
- irrelevant mate
A/State Director TAS 
S22(1)(a)(ii) - irrelevant material  
Andrew.S22(1)(a)(ii) 
@ndi
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scommission.gov.au 
Commission    
Low/medium Risk escalations 
 
NDIS 
Samantha S22(1)(a)(ii) - irreleva  
State Director VIC 
S22(1)(a)(ii) - irrelevant material  
SamanthaS22(1)(a)(ii) 
@n
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discommission.gov.au 
Commission    
Low/medium Risk escalations 
NDIS 
Mahashini S22(1)(a)(ii) 
 
- irrelevant 
State Director NSW/ACT 
S22(1)(a)(ii) - irrelevant material  
Mahashini.S22(1)(a)(ii) 
@ndiscommissio
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n.gov.au   
Commission    
Low/medium Risk escalations 
 
 
 
NDIS 
Rowena S22(1)(a)(ii) 
 
- irrelevant materia
Director, Participant Rights 
S22(1)(a)(ii) - irrelevant material  
Rowena.S22(1)(a)(ii) 
@ndiscommissio
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n.gov.au 
Commission 
Policy, Markets and Insight 
 
Division 
NDIS 
Miriam S22(1)(a)(ii) - irrelevant material 
Assistant Director Participant 
S22(1)(a)(ii) - irrelevant material  
Miriam.S22(1)(a)(ii) - irrelevant xxxxxxxx@xxxxxxxxxxxxxx.xxx.a
Commission 
 
Rights,   
 
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Policy, Markets and Insight 
Division 
NDIS 
Jan S22(1)(a)(ii) 
 
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National Director Complaints 
S22(1)(a)(ii) - irrelevant material  
Jan.S22(1)(a)(ii) 
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discommission.gov.au 
Commission 
Strategy 
 
 
 
 
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